Positioning device for use with a patient under anesthesia and associated methods

ABSTRACT

The present invention provides devices for use with a patient under anesthesia and associated methods. Various embodiments of the present invention include a device for establishing and maintaining a patient&#39;s head and/or jaw in a particular position, including the sniffing position. Embodiments also include a method for positioning a patient comprising the use of a device of the present invention, wherein the device may substantially maintain a patient in a desired position.

RELATED APPLICATION

This application is a continuation of and claims the benefit of U.S.Patent application Ser. No. 12/209,003, entitled “Positioning Device ForUse With A Patient Under Anesthesia And Associated Methods,” filed Sep.11, 2008, now U.S. Patent No. ______, which is hereby incorporatedherein by reference in its entirety.

FIELD OF THE INVENTION

The invention relates to surgical devices for positioning a patient,including a patient under general anesthesia or sedation, and in someembodiments to surgical devices for establishing and maintaining apatient's head and/or jaw in a particular position.

BACKGROUND OF THE INVENTION

Millions of surgeries and invasive diagnostic procedures are performedin the United States every year. Most, if not all, of these surgeriesand procedures involve the use of some form of anesthesia or sedation.In some cases, general anesthesia is used that renders the patientunconscious. Generally, before and/or during such surgeries, a doctor(an “anesthesiologist” or an “oral surgeon”) and/or Certified RegisteredNurse Anesthetist) administers the anesthetics and monitors the patientwhile the patient is under anesthesia or sedation.

The job of the anesthesiologist or anesthetist is not a simple one. Withmodern anesthesia, a wide variety of medical equipment may be used.Anesthesia practitioners must possess a comprehensive and intricateknowledge of the use of various medical gases, anesthetic agents andvapors, medical breathing circuits and the variety of anestheticmachines vaporizers, ventilators and pressure gauges) and theircorresponding safety features, hazards and limitations. Moreover, apatient being treated under general anesthetics must be monitoredcontinuously to ensure the patient's safety. For minor surgery, thisgenerally includes monitoring of things such as heart rate, oxygensaturation, non-invasive blood pressure, inspired and expired gases (foroxygen, carbon dioxide, nitrous oxide, and volatile agents). Formoderate to major surgery, monitoring may also include temperature,urine output, invasive blood pressure measurements, pulmonary arterypressure and pulmonary artery occlusion pressure, cerebral activity,neuromuscular function, and cardiac output. The various pieces ofequipment and considerations can keep an anesthesiologist or anesthetistquite occupied before, during and after a surgical procedure.

Not surprisingly, an important consideration while a patient s undersedation or general anesthesia is insuring the patient can breatheproperly. In some instances physically invasive methods, such as theinsertion of tubes, are required. It has been shown, however, thatpositioning of the patient plays a role in ensuring the patient canbreathe properly. For example, placing and keeping a patient in certainpositions (e.g., the “sniffing” position) helps to ensure that apatient's airways is not obstructed. Thus, positioning of the patient isanother condition that an anesthesiologist or anesthetist may need tomonitor during a procedure. Therefore a method or device that aids theplacing of a patient in a position that facilitates breathing and/ormaintains the patient in that position during a procedure may ease theburden on an attending anesthesia practitioner before, during and aftera surgical or similar procedure. Such a method or device may have broadapplications in medicine and dentistry, including any situation where apatient is unconscious and/or immobilized whether or not that patient isunder anesthesia.

SUMMARY OF THE INVENTION

In some embodiments, the present invention includes a device including:a base comprising a first side and a second side, wherein the base isconfigured to substantially accommodate a patient's head; a firstsupport positioned on the first side of the base; a second supportpositioned on the second side of the base; a first mandible armpositioned on the first support, wherein the first mandible arm isconfigured to contact a patient's jaw; a second mandible arm positionedon the second support, wherein the second mandible arm is configured tocontact a patient's jaw; wherein the first mandible arm and the secondmandible arm are movable in three axes such that each is positionable tobe in contact with a patient's jaw and to maintain a patient in adesired position. In certain embodiments, the base is rectangular. Insome embodiments, the mandible arm is positionable to be in contact witha patient's jaw at three points. In further embodiments, the firstmandible arm and the second mandible arm each include a mandible pad. Inyet further embodiments, the first mandible arm and the second mandiblearm are removably connected to the first support and the second support,respectively. In other embodiments, the first mandible arm is movablerelative to the first support and the second mandible arm is movablerelative to the second support. In some embodiments, the three axes arethe x, y and w axes relative to the patient. In various embodiments, thedesired position is the sniffing position. In certain embodiments, themandible pad comprises foam. In further embodiments, the mandible arm ispositionable such that the mandible pad is in contact with a patient'sjaw at one or more points. In some embodiments, the mandible arm ispositionable such that the mandible pad is in contact with a patient'sjaw at three points. In yet other embodiments, the first support ismovable relative to the base and the second support is movable relativeto the base. In various embodiments, the first support is movablerelative to the base in two axes and the second support is movablerelative to the base in two axes. In some embodiments, the first supportis movable relative to the base in three axes and the second support ismovable relative to the base in three axes. In other embodiments, thefirst support is movable relative to the first mandible arm and thesecond support is movable relative to the second mandible arm.

In other embodiments the present invention includes a device including:a base comprising a plurality of supports, wherein the base isconfigured to substantially accommodate a patient's head, wherein eachsupport comprises a mandible arm, wherein each mandible arm isconfigured to contact a patient's jaw; and wherein each mandible arm ismovable in three axes such that each mandible arm is positionable to bein contact with a patient's jaw and to maintain a patient in a desiredposition. In certain embodiments, the base is rectangular. In otherembodiments, each mandible arm is positionable to be in contact with apatient's jaw at three points. In further embodiments, each mandible armcomprises a mandible pad. In yet further embodiments, each mandible armis removably connected to each support. In some embodiments, eachmandible arm is movable relative to a support. In other embodiments, thethree axes are the x, y and w axes relative to the patient. In yet otherembodiments, the desired position is the sniffing position. In variousembodiments, each mandible pad includes foam. In certain embodiments,each mandible arm is positionable such that the mandible pad is incontact with a patient's jaw at one or more points. In certainembodiments, each mandible arm is positionable such that the mandiblepad is in contact with a patient's jaw at three points. In furtherembodiments, each support is movable relative to the base. In yetfurther embodiments, each support is movable relative to the base in twoaxes. In other embodiments, each support is movable relative to themandible arms.

In other embodiments, the present invention includes methods, The methodmay be a method for positioning a patient including the steps of:providing any embodiment of the devices of the present invention,placing the patient's head substantially on the base of the device;placing the patient's head in a desired position; moving a firstmandible arm to contact the patient's jaw; moving a second mandible armto contact the patient's jaw; wherein the contact of the first mandiblearm and the second mandible arm provides sufficient force tosubstantially maintain the patient's head and/or jaw in a desiredposition.

In yet other embodiments, the present invention includes a mandible aimincluding: a curved portion, wherein the curved portion is substantiallyrigid; a mandible pad, wherein the mandible pad is flexible, and whereinthe mandible pad has a distal side configured to attach to the curvedportion and a proximal side configured to contact a patient's jaw at aplurality of points; and a connector portion wherein the connectorportion is configured to attach to a support. In some embodiments, themandible arm may be adapted to work with any embodiment of the devicesof the present invention. In other embodiments, the mandible padcomprises foam. In yet other embodiments, the connector portion isconfigured to attach to a support that is attached to a base comprisinga left side and a right side, wherein the base is configured tosubstantially accommodate a patient's head, and wherein the support ismovable in three axes such that the mandible pad is positionable to bein contact with a patient's jaw at one or more points and to maintain apatient in a desired position.

BRIEF DESCRIPTION OF THE FIGS.

FIG. 1 is a schematic diagram providing a top view of an embodiment of adevice of the present invention.

FIGS. 2A-2B are schematic diagrams providing a side view of anembodiment of the present invention.

FIGS. 3A-3B are schematic diagrams of an embodiment of a device of thepresent invention.

FIGS. 4A-4E are schematic diagrams providing multiple views ofembodiments of a mandible pad of the present invention.

FIGS. 5A-5C are schematic diagrams of an embodiment of a support of thepresent invention.

FIG. 6 is a schematic diagram providing a side view of an embodiment ofa device of the present invention.

DETAILED DESCRIPTION

In the following paragraphs, the present invention will be described indetail by way of example with reference to the attached drawings.Throughout this description, the preferred embodiment and examples shownshould be considered as exemplars, rather than as limitations on thepresent invention. As used herein, the “present invention” refers to anyone of the embodiments of the invention described herein, and anyequivalents. Furthermore, reference to various feature(s) of the“present invention” throughout this document does not mean that allclaimed embodiments or methods must include the referenced feature(s).

It is understood that the terminology used herein is used for thepurpose of describing particular embodiments only, and is not intendedto limit the scope of the present invention. It must be noted that asused herein and in the appended claims, the singular forms “a,” “an,”and “the” include the plural reference unless the context clearlydictates otherwise. Thus, for example, a reference to “a support” is areference to one or more supports and includes equivalents thereof knownto those skilled in the art and so forth.

The present invention includes devices and methods. The devices of thepresent invention include devices for positioning a patient. In someembodiments, the devices may be used for positioning and/or maintaininga patient in a given position before, during and/or after a medical(including surgical), dental or diagnostic procedure. In manyembodiments, the patient is under sedation or general anesthesia, and insome embodiments the patient may be rendered unconscious by generalanesthesia. In some embodiments, the positioning of the patientfacilitates or eases the breathing of the patient, for example byensuring anatomical alignment of the patient's airway. The devices mayposition the patient in the “sniffing” position or a similar position.The devices of the present invention may, for example, allow ananesthesiologist or anesthetist place and maintain a patient in adesired position. In some embodiments the devices of the presentinvention permit a person to place a patient in a specific position in aquick and efficient manner. The devices of the present invention haveapplications in both medicine and dentistry and references to a“procedure” or a “surgical procedure” refer to various medicalprocedures, diagnostic procedures and dental procedures, including oralsurgeries, root canals, removal of teeth, and others.

The methods of the present invention include methods of positioning apatient. Some methods may include the positioning and/or maintaining ofa patient in a given position before, during and/or after a surgical,diagnostic or dental procedure. Some methods of the present inventionmay involve the use of a device of the present invention. Someembodiments involve the positioning of a patient in a position that mayease or facilitate the breathing of the patient, for example the“sniffing” position. In many embodiments, the patient is under sedationor anesthesia, including a patient that is rendered unconscious bygeneral anesthesia or sleepy after general anesthesia.

With reference to FIG. 1, an embodiment of a device of the presentinvention is illustrated. Base 10 is depicted as having left side 20,right side 30, upper side 40, and lower side 50. In the illustratedembodiment, base 10 is rectangular, but it may have any suitable shape.Base 10 may be made of any suitable material, including materials thatare Magnetic Resonance Imaging (“MRI”) compatible, washable and/orsterilizable. In some embodiments, base 10 may be made of medical gradeplastic or closed-cell foam. Base 10 may also be made of various otherMRI compatible materials, including plastics, resins, resinoids,polymers, cellulose derivatives, casein materials, and metals. Base 10may also include a cover on all or a portion of base 10. For example,such cover may be made of soft or hard foam, fabric, or cushionedmaterial. Such materials may also be integral with a portion of base 10.

In some embodiments, base 10 may also have an alignment guide 155.Although alignment guide 155 is illustrated as an alignment line in FIG.1, it may be any suitable structure or element. For example, alignmentguide 155 may be an outline, an arrow, a notch or series of notches, anindentation, or any suitable structure. Alignment guide 155 provides avisual guide to a person attempting to place a patient in a desiredposition. Thus, alignment guide 155 may be movable or have multiplepositions or designations that depend upon the desired position of thepatient. In embodiments where alignment guide 155 is a line on base 10,the line may be approximately in line with the mandible arm 120; thepatient's lip may then be placed approximately in line with thealignment guide 155. In addition, the patient is adjusted such that themandible pad 130 may align with the patient's jaw.

With reference to FIGS. 2A-B, gripping element 160 is also depicted.Gripping element 160 may be any suitable structure having u any suitablesize and configuration. For example, gripping element 160 may be aprotrusion or a depression, or any other structure or texture thatfacilitates movement of base 10 by a person.

Returning to FIG. 1, base 10 has width 60 and length 70. Width 60 may beany suitable width and may be substantially uniform or substantiallynon-uniform along length 70. Generally, width 60 is sufficient toaccommodate, or substantially accommodate, the width of the head of apatient. In some embodiments, width 60 may vary depending upon theintended or desired use of a particular device—for example a base 10that is to be used for pediatric patients may have a width 60 that isless than the width 60 of a base 10 that is to be used for adultpatients. In other embodiments base 10 has a width 60 that is usablewith both adult and pediatric patients. In certain embodiments, width 60may be from about three inches to about eighteen inches. In otherembodiments, width 60 may be from about six to about ten inches. Infurther embodiments, width 60 may be about six and three quartersinches.

Similarly, length 70 may be any suitable length. Generally, length 70 issufficient to accommodate, or substantially accommodate, the length ofthe head of a patient. Length 70 may also be sufficient to accommodate,or substantially accommodate, a patient's neck. In some embodiments,length 70 may vary depending upon the intended or desired use of aparticular device—for example a base 10 that is to be used for pediatricpatients may have a length 70 that is less than the length 70 of a base10 that is to be used for adult patients. In other embodiments base 10has a length 70 that is usable with both adult and pediatric patients.In certain embodiments, length 70 may be from about eight inches toabout thirty-six inches. In other embodiments, length 70 may be fromabout twelve to about twenty-four inches. In some embodiments, length 70may be divided into one or more zones or areas having differentcharacteristics, including one or more of material, height, and grade(or slope). Length 70 may have any suitable number of zones having anysuitable characteristics. In the illustrated embodiment, length 70 isseparated into three zones: raised zone 80, sloped zone 90, anddepressed zone 100.

FIG. 2A depicts a side view of left side 20 of an embodiment of thepresent invention. The side view better illustrates an embodiment havingraised zone 80, sloped zone 90, and depressed zone 100, such that thedifferences in the depicted zones are more readily apparent. Raised zone80 is generally disposed near upper side 40 and has a height 170 that isgreater than the height of depressed zone 100, which is generallydisposed near lower side 50. Sloped zone 90 comprises the transitionfrom the greater height 170 of raised zone 80 to the lower height ofdepressed zone 100. Sloped zone 90 may have a constant or variable slopeand the slope may be of any suitable magnitude. In some embodiments,raised zone 80, sloped zone 90 and depressed zone 100 are generallyconfigured to accommodate a patient's head and neck, with sloped zone 90approximately in line with the patient's neck. FIG. 2B shows anembodiment similar to FIG. 2A. FIG. 2B depicts an embodiment of base 10having only a raised zone 80 and sloped zone 90.

Height 170 may be any suitable height. Preferably, height 170 issufficient to raise a patient's head a suitable distance such that thepatient's head may be placed in the “sniffing” position or such otherposition as may be desired, for example to provide improved, eased orconsistent breathing by the patient. As discussed above, height 170 maybe constant over length 70 or it may be variable. In some embodiments,height 170 may be from about one quarter of an inch to about six inches.In other embodiments, height 170 may be from about one inch to aboutthree inches. In sonic embodiments the height of raised zone 80 is fromabout two inches to about four inches and the height of depressed zone100 is from about one quarter of an inch to about one inch.

Returning to FIG. 1, base 10 is depicted with a support 110 on each ofright side 30 and left side 40. Support 110 may be integral with base 10or support 110 may be removable from base 10. Each support 110 isattached to a mandible arm 120 having a mandible pad 130. In someembodiments both the support width 140 and the mandible gap 150 areadjustable. Support width 140 represents the distance from the outsideedge of one support 110 to the outside edge of the opposite support 110.In some embodiments, support width 140 is adjustable by movement ofsupport 110 (or by varying the width of base 10). Support width 140 maybe any suitable width, but generally is a width sufficient toaccommodate the width of the head of a patient. In some embodiments,support width 140 may be from about two to about twelve inches, fromabout four to about eight inches, from about five to about seven inches,about eight inches, or any suitable width or range of widths. Mandiblegap 150 represents the distance between the medial edge of mandible arm120 on one side of base 10 to the medial edge of mandible arm 120 on theopposite side of base 10. In some embodiments, mandible gap 150 isadjustable by movement of support 110 and/or mandible arm 120. Mandiblegap 150 may be any suitable distance, but generally is a distancesufficient to accommodate the width of a patient's jaw. In someembodiments, mandible gap 150 may be from about two to about eightinches, from about three to about six inches, from about three to aboutfive inches, about five inches, or any suitable distance or range ofdistances.

FIG. 3A illustrates a bottom view of an embodiment of a device of thepresent invention. Bottom surface 180 of base 10 is depicted. In thisembodiment bottom surface 180 has non-skid surface 190. Otherembodiments of bottom surface 180 may not have non-skid surface 190 andmay have other suitable structures or features. Non-skid surface 190 maybe any surface that permits movement of base 10 when the patient is noton base 10, yet inhibits movement of base 10 when a patient is placed onbase 10. Non-skid surface 190 may encompass all or only a part of bottomsurface 180. For example, non-skid surface 190 may be a rubberized ortacky surface, a textured surface, or any other suitable substance ortexture.

FIG. 3A depicts an embodiment having a support 110 that may be removablyattached to base 10. In other embodiments, support 110 may be fixedlyattached to base 10 or integral with base 10. Support 110 is illustratedhaving an insertion portion 200. With reference to FIG. 3B, a patient1000 is depicted on base 10. Also illustrated is a slot 210. Insertionportion 200 is configured to fit within slot 210. In turn, slot 210 isconfigured to receive insertion portion 200. Although slot 210 andinsertion portion 200 are depicted as rectangular, each may have anysuitable shape, size or configuration. For example, slot 210 andinsertion portion 200 may be cylindrical, triangular, or any othersuitable shape. In addition, slot 210 and insertion portion 200 couldalso be a plurality of slots and/or insertion portions. For example,insertion portion 200 could comprise two rectangular portions configuredto insert into a slot 210 that comprises two rectangular slots.

Continuing with reference to FIG. 3A, in some embodiments insertionportion 200 has a connector 220 that is engageable with an elementwithin slot 210 such that insertion portion 200 is locked into aposition or is lockable into a variety of positions once inserted intoslot 210. Connector 220 may be any suitable structure having anysuitable configuration. In some embodiments, connector 220 may be agrooved structure that protrudes from insertion portion 200 such that itextends to engage an element within slot 210. In some embodiments,button 230 may be used to selectively engage/disengage (e.g., extendand/or retract) connector 220, such that insertion portion 200 may bepushed into or pulled out of slot 210 in selected increments. Withreference back to FIG. 1, such movement ay adjust support width 140and/or mandible gap 150. Button 230 may be any suitable structure may beused to control the degree of insertion of insertion portion 210.Support 110 is described in greater detail with reference to FIGS.5A-5B.

FIGS. 4A-4E provide close-ups of embodiments of mandible arm 120.Mandible arm 120 may be custom sized to fit a particular patient or itmay be sized such that it fits a number of patients. For example,mandible arm 120 may be smaller for pediatric patients than for adultpatients, or mandible arm 120 may be available in a variety of sizes.Mandible arm 120 may be removably or fixedly attached to support 110 orit may be integral with support 110. In some embodiments, mandible arm120 may be disposable, but in other embodiments it may be reusable,washable, and/or sterilizable. In some embodiments the shape of mandiblearm 120 is such that a patient may be engaged with a device of thepresent invention and have a standard oxygen mask attached over thepatient's mouth and/or nose.

In the depicted embodiment, mandible arm 120 includes mandible pad 130,curved portion 300 and arm portion 340. Curved portion 300 may be madeof any suitable material and may have any suitable configuration. Inpreferred embodiments, curved portion 300 is substantially rigid,elongate, concave and has a curvature that facilitates effective contactwith a patient's jaw. In some embodiments, the shape of curved portion300 provides shape to mandible pad 130. In some embodiments, curvedportion 300 is configured such that mandible arm 120 is configured tocontact a patient's jaw at one or more points. In some embodiments,curved portion 300 is configured to contact the patients jaw at two orthree points. In certain embodiments. curved portion 300 is configuredto facilitate contact of mandible arm 120 with the ramus of a patient'sjaw, the body of the patient's jaw and the angle of a patient's jaw. Inother embodiments, curved portion 300 may be non-rigid, or havenon-rigid portions, and may even be substantially lacking in curvature.In certain embodiments, curved portion 300 is made of a medical gradeplastic, but curved portion 300 may be made of other materials, such asvarious other plastics, resins, resinoids, polymers, cellulosederivatives, casein materials, glass, and metals.

Curved portion 300 is illustrated as having lower end 310 and upper end320. In the illustrated embodiments, lower end 310 is oriented towardlower side 50 of base 10 and upper end 320 is oriented toward upper side40 of base 10. Also depicted on curved portion 300 is tubing grip 330.Tubing grip 330 may be any structure or structures configured to gripand hold tubing that may be attached to tools or equipment used during,prior to, or after a surgical, or similar, procedure is performed. Forexample, tubing grip 330 may be used to grip tubing that leads to anoxygen mask placed over the mouth and nose of a patient. In FIG. 4A,tubing grip 330 is illustrated as a pair of ribs spaced apart a suitabledistance to permit the ribs to grip tubing without substantiallyimpairing the flow of gas through the tubing. In FIG. 4D, tubing grip330 is depicted as a pair of pillars also spaced apart a suitabledistance to permit the ribs to grip tubing without substantiallyimpairing the flow of gas through the tubing. In some embodiments thedistance between the ribs and/or pillars is from about 1 mm to about 5mm. In other embodiments, the distance between the ribs and/or pillarsis about 2 mm. In yet further embodiments, the distance between the ribsand/or pillars is about 2.8 mm.

Returning to FIG. 4A, arm portion 340 extends medially from curvedportion 300 and is configured to engage support 110. Although depictedas approximately cylindrical with flat surface 350, arm portion 340 mayhave any suitable shape, size and configuration, and may be made of anysuitable material. Arm portion 340 may be removably or fixedly attachedto support 110 and in some embodiments arm portion 340 may be integralwith support 110. Arm portion 340 also may be keyed such that it willonly attach to the appropriate support 110—for example, an arm portion340 for use with a support 110 on left side 20 of base 10 may beconfigured such that it will only attach to that support 110. In theillustrated embodiment, arm portion 340 has flat surface 350 and medialend 360.

With reference to FIG. 4C, mandible pad 130 is highlighted. FIG. 4Cillustrates mandible arm 120, with arm portion 340, curved portion 300and mandible pad 130. Mandible pad 130 may be made of any suitablematerial having any suitable size, shape, and properties. In someembodiments, mandible pad 130 is elongate, but in other embodiments itmay be oval, circular, rectangular or any other suitable shape. Incertain embodiments mandible pad 130 may be flexible, but in otherembodiments it may be malleable, resilient, rigid or any other suitableconsistency. Mandible pad 130 may be made of molded or flat foam, but inother embodiments it may be made of medical grade plastic or moldoverfoam, other plastics, rubber, resins, metals or any other suitablematerial. In further embodiments mandible pad 130 may be disposable, butin other embodiments it may be reusable, washable, and/or sterilizable.Mandible pad 130 may be removably or fixedly attached to curved portion300. In some embodiments mandible pad 130 may be attached by glue,epoxy, cement or the like, but in other embodiments mandible pad 130 maybe attached to curved portion 300 in any suitable manner. In preferredembodiments, mandible pad 130 is made of flexible foam, elongate andfixably attached to curved portion 300 with a glue or epoxy.

In some embodiments, mandible pad 130 is configured to contact apatient's jaw at one or more points. In some embodiments, mandible pad130 is configured to contact the patient's jaw at two or three points.For example, with reference to FIG. 6, a patient 1000 having jaw line900 is depicted on a device of the present invention having base 10 withupper side 40, lower side 50, support 110, and mandible arm 120 havingmandible pad 130. Jaw line 900 has multiple portions corresponding todifferent portions of the patient's jaw bone. Ramus 930 corresponds tothe edge of the ramus of the patient's jaw bone, body 910 corresponds tothe edge of the body of the patient's jaw bone, and angle 920corresponds to the edge of the angle of the patient's jaw bone. Incertain embodiments, mandible pad 130 is configured to contact the ramus930 of a patient's jaw, the body 910 of the patient's jaw and the angle920 of a patient's jaw. Of course, references to such contact here andin other portions of this disclosure do not refer to direct contact, butrather refer to indirect contact by contact of the patient's skin.

With reference now to FIG. 4C, mandible pad 130 has distal surface 400,medial surface 410, height 420, width 460 and extends distance 430 awayfrom curved portion 300. Height 420 may be any suitable height. Forexample, height 420 may be from about one tenth of an inch to about 5inches, from about one quarter of an inch to about one and a halfinches, from about one half of an inch to one inch, or any othersuitable height. Similarly, distance 430 may be any suitable distance.For example, distance 430 may be from about one tenth of an inch toabout five inches, from about one quarter of an inch to about one andone half inches, from about one half of an inch to one inch, or anyother suitable height. Additionally, width 460 may be any suitablewidth. For example, width 460 may be from about one eighth of an inch toabout four inches, about one half of an inch to about two and a halfinches, about one inch to about two inches, or any other suitable width.The depicted embodiment has a medial surface 410 that has depression 450having depth 440. In other embodiments, medial surface 410 may be flat,substantially flat or even convex. Although depicted as rounded,depression 450 may have any suitable shape. In addition, medial surface410 may have multiple depressions 450 of similar, different or identicalconfigurations. Depression 450 may be uniform or substantially uniformalong the length 470 (depicted in FIG. 4E) of mandible pad 130 or itspresence or characteristics may vary over the length 470 of mandible pad130. For example depth 440 of depression 450 may be substantiallyconstant or may vary along the length 470 of mandible pad 130. Depth 440may be any suitable depth from the highest point of medial surface 410.For example, depth 440 may be from about one sixteenth of an inch toabout one inch, from about one eighth of an inch to about three quartersof an inch, from about one quarter of an inch to about one half of aninch, or any suitable depth. Similarly, length 470 may be any suitablelength. For example, length 470 may be from about one inch to aboutseven inches, from about two inches to about five inches, from about twoand one half inches to about four inches, about three and one halfinches, or any other suitable length.

With reference to FIG. 4E is a top view of an embodiment of mandible arm120 and mandible pad 130. This figure depicts length 470 as describedabove. This figure also illustrates an embodiment of mandible arm 120that, because of the curvature of curved portion 300, has a first length480 and a second length 490. In preferred embodiments first length 480is greater than second length 490. In some embodiments, first length 480is from about one inch to about five inches, from about one and a halfinches to about four inches, from about two and a half inches to aboutthree and a half inches, about three inches, or any other suitablelength. In some embodiments, second length 490 is from about one halfinch to about five inches, from about from about one inch to about fourinches, from about two and inches to about three inches, about two and ahalf inches, or any other suitable length. In one embodiment, firstlength 480 is about three inches and second length 490 is about two andone half inches.

FIGS. 5A-5C are close-ups of embodiments of support 110. In theillustrated embodiment, support 110 has a first portion 500, a secondportion 510 and a third portion 560 that may be removably or fixedlyattached to each other and/or base 10. In other embodiments support 110may be a unitary structure and/or may be integral with base 10 and/ormandible arm 120. Although depicted as having various parts havingspecific shapes and connections, support 110 may have any suitableconfiguration and have any suitable shape.

In preferred embodiments, support 110 is adjustable in at least oneaxis. In some embodiments support 110 is adjustable in an x-axis (forexample, as defined by insertion portion 200 and mandible gap 150 (seeFIG. 1) and/or a y-axis (for example, as defined by height 620 of upperportion 610). In other embodiments support 110 may also be adjustable ina z-axis (for example and with reference to FIG. 1, as defined by theedge of left side 20 of base 10) and/or a w-axis (for example, definedas by rotation of third portion 560). In preferred embodiments, support110 is adjustable in at least the x, y and w axes.

In some embodiments, the adjustment of support 110 places mandible arm120 in contact with a patient's jaw at two or three points. In someembodiments, adjustment of support 110 results in placing and/or holdingthe patient in a desired position. In some embodiments, the desiredposition is the sniffing position. For example, with reference to FIG.6, a patient 1000 having jaw line 900 is depicted on a device of thepresent invention having base 10 with upper side 40, lower side 50,support 110, and mandible arm 120 having mandible pad 130. Jaw line 900has multiple portions corresponding to different portions of thepatient's jaw bone. In certain embodiments, support 110 is adjustablesuch that mandible arm 120 may be moved to contact the ramus 930 of apatient's jaw, the body 910 of the patient's jaw and the angle 920 of apatient's jaw.

With reference to FIG. 5A, an embodiment of first portion 500 of support110 is depicted. First portion 500 has length 600, a first height 590, asecond height 620, connector 220, button 230, insertion portion 200 andupper portion 610. Connector 220, button 230 and insertion portion 200were described with reference to FIGS. 3A-3B. As illustrated, insertionportion 200 has length 600, width 580 and height 590, each of which maybe any suitable magnitude. For example, length 600 may be from about oneinch to about eight inches, from about two inches to about five inches,from about two and a half inches to about four inches, from about threeto about three and a half inches, or any suitable length. For example,width 580 may be from about one half of one inch to about six inches,from about one inch to about three inches, from about one and a halfinches and about two and a half inches, or any suitable width. Forexample, height 590 may be from about one eighth of an inch to aboutthree inches, from about one quarter of an inch to about one and a halfinches, from about a half an inch to about an inch, or any suitablethickness.

Similarly, upper portion 610 may have a length 620 that is similar ordifferent than that of insertion portion 200. For example, length 600may be from about one inch to about eight inches, from about two inchesto about five inches, from about two and a half inches to about fourinches, from about three to about three and a half inches, or anysuitable length. The other dimensions of upper portion 610 may be ofdimensions similar to those described with respect to insertion portion200. Upper portion 610 may also have a connection element thatfacilitates or accomplishes connection between first portion 500 andsecond portion 510 of support 110.

Continuing with reference to FIG. 5A, an embodiment of second portion510 is illustrated. Second portion 510 has height 630, width 640 andthickness 690, each of which may be any suitable magnitude. For example,height 630 may be from about one inch to about eight inches, from abouttwo inches to about five inches, from about two and a half inches toabout four inches, from about three to about three and a half inches, orany suitable height. For example, width 640 may be from about one halfof one inch to about six inches, from about one inch to about threeinches, from about one and a half inches and about two and a halfinches, or any suitable width. For example, thickness 690 may be fromabout one eighth of an inch to about three inches, from about onequarter of an inch to about one and a half inches, from about a half aninch to about an inch, or any suitable thickness. In some embodimentsthickness 690 and width 640 are greater than the correspondingdimensions of upper portion 610 of first portion 500 such that at leastpart of first portion 500 fits within second portion 510. Preferably,the dimensions are sufficiently greater such that the overall height ofsupport 110 is adjustable by movement of second portion 510 along they-axis over upper portion 610 of first portion 500 of support 110. Inother embodiments, the dimensions of first portion 500 may be greaterthan those of second portion 510 such that at least a part of secondportion 510 fits within first portion 500.

Second portion 510 also has first portion connector 700 and thirdportion connector 520. First portion connector 700 may be any suitablestructure that facilitates connection between second portion 510 andfirst portion 500 of support 110. Preferably, first portion connector700 interacts with an element on first portion 500 such that secondportion 510 may be selectively moved relative to first portion 500. Insome embodiments, first portion connector 700 is selectivelyengaged/disengaged with an element of first portion 500 by heightadjustment button 540 (see FIG. 513). In such embodiments, depressingheight adjustment button 540 disengages first portion connector 700 andpermits movement of second portion 510 relative to first portion 500along the y-axis. Releasing height adjustment button 540 would thenengage first portion connector 700 such that second portion 510 would belocked into place along the y-axis. In some embodiments, first portionconnector 700 interacts with height adjuster 720 in third portion 560(see FIG. 5B). In such an embodiment depressing height adjustment button540 causes height adjuster 720 to interact with first portion connector700 such that it disengages from the element in first portion 500,thereby permitting movement of second portion 510 along the y-axisrelative to first portion 500.

Second portion 510 also has third portion connector 520. Third portionconnector 520 may be any suitable structure that facilitates connectionbetween second portion 510 and third portion 560. In the depictedembodiment, third portion connector is a cylindrical extension formsecond portion 510 that fits within orifice 680 (see FIG. 5B) of thirdportion 570. Third portion connector 520 and orifice 680 may have anysuitable size and characteristics.

With reference now to FIGS. 5B and 5C, preferably, second portionconnector 520 interacts with rotation adjuster 710 on third portion 560such that third portion 560 may be selectively moved relative to secondportion 510. In some embodiments, third portion connector 520 isselectively engaged/disengaged with rotation adjuster 710 by rotationadjustment button 550 (see FIG. 5B). In such embodiments, depressingrotation adjustment button 550 disengages third portion connector 520from rotation adjuster 710 and permits movement of third portion 560relative to second portion 510 along the w-axis. Releasing rotationadjustment button 550 would then engage second portion connector 520from rotation adjuster 710 such that third portion 560 would be lockedinto place along the w-axis.

With reference again to FIGS. 5B and 5C, an embodiment of third portion560 is illustrated. Third portion 560 has rotation adjustment button550, height adjustment button 540, mandible arm receiver 530, mainportion 570, orifice 680, rotation adjuster 710 and height adjuster 720.Although depicted as buttons, rotation adjustment button 550 and heightadjustment button 540 may be any suitable structure that may bemanipulated by a person. In addition, rotation adjustment button 550 andheight adjustment button 540 may be placed on any suitable location onsupport 110 (even on each of the different portions described herein) oron other parts of the device. Preferably, rotation adjustment button 550and height adjustment button 540 are positioned such that a person couldplace his/her hand on support 110 and interact with both.

Third portion 560 may have any suitable configuration and be anysuitable shape. Thus, although in the illustrated embodiment thirdportion 560 is substantially circular, it may be any suitable shape. Inpreferred embodiments, third portion 560 rotates in a w-axis, such thatmandible arm 120 moves in a w-axis. In some embodiments this movementaids positioning of mandible arm 120 with respect to a patient and, morespecifically, the patient's jaw bone. Preferably, third portion 560 isconfigured such that it may be grasped and manipulated by a human hand.Thus, preferably a person could grasp third portion 560 such that theperson could interact with rotation adjustment button 550 and heightadjustment button 540 in a manner that would permit the person to adjustsupport 110, thereby adjusting/positioning mandible arm 120. By sodoing, a person could then cause mandible arm 120 to contact a patientsuch that the patient may be placed and/or held in a desired position,for example the sniffing position.

Main portion 560 is depicted as circular, but it may be any suitableshape. Main portion 560 has height 650 and width 670, which may be equalor different and may have any suitable magnitude. For example, height650 may be may be from one inch to about eight inches, from about twoinches to about five inches, from about two and a half inches to aboutfour inches, from about three to about three and a half inches about onehalf of one inch to about six inches, from about one inch to about threeinches, from about one and a half inches and about two and a halfinches, or any suitable height. For example, width 670 may be from oneinch to about eight inches, from about two inches to about five inches,from about two and a half inches to about four inches, from about threeto about three and a half inches about one half of one inch to about sixinches, from about one inch to about three inches, from about one and ahalf inches and about two and a half inches, or any suitable length.

With reference again to FIGS. 5B and 5C, third portion 560 also hasmandible arm receiver 530. Mandible arm receiver interacts with armportion 340 of mandible arm 120 (see FIGS. 4A-4E). Mandible arm receiver530 may have any suitable length. For example, mandible arm receiver 530may be from about one eighth of an inch to about three inches, fromabout one quarter of an inch to about one and a half inches, from abouta half an inch to about an inch, or any suitable thickness. Mandible armreceiver 530 may also have any suitable configuration and/or shape.Thus, although in the depicted embodiment mandible arm receiver 530 maybe substantially cylindrical, it may be any suitable structure. In thedepicted embodiment distal end 360 (see FIG. 4A) is inserted intomandible arm receiver 530 and mandible arm receiver 530 holds mandiblearm 120 in place via its connection with arm portion 340. Arm portion340 may be removably, adjustably or fixedly attached to mandible armreceiver 530 and arm portion 340 may be integral with mandible armreceiver 530. Mandible arm receiver 530 may also have a release button370. Release button 370 directly or indirectly interacts with armportion 340 to permit insertion and/or removal of arm portion 340 intoand/or from mandible arm receiver 530. Release button 370 may alsopermit adjustment of the extent of insertion of arm portion 340 intomandible arm receiver 530, such that the distance between mandible arm120 and third portion 560 may be increased or decreased. Such movementwould also permit adjustment of mandible gap 150 (see FIG. 1). Releasebutton 370 may be any suitable structure, including a button, latch,switch or dial. Release button 370 may also be placed on any suitablelocation on the device.

In some embodiments arm portion 340 has flat portion 350 that interactswith a surface within mandible arm receiver 530. In some embodiments,this interaction prevents one from inserting the right mandible arm 120into the left support 110, and vice-versa.

With reference now to FIG. 5C in certain embodiments, mandible arm 120may be connected to third portion 560 in a manner that permits movementof mandible arm 120 relative to support 110. For example, mandible arm120 may be movable in one or more axes, including the x, y and z axesrelative to support 110. In such embodiments the movement of mandiblearm 120 may facilitate placing and/or maintaining a patient in a desiredposition, including the sniffing position.

In addition to the various devices described herein, the presentinvention also includes methods. Generally, the methods of the presentinvention relate to placing and/or maintaining a patient in a desiredposition. In some embodiments, this is a position that facilitatesregular or semi-regular breathing by a patient that is under sedation orgeneral anesthesia. For example, the desired position may be thesniffing position. The methods may include the use of various equipment,such as an O₂ or face mask with associated tubing in order to providemask ventilation, various other breathing apparatuses, including tubesat least partially inserted into the patient. Various embodiments of themethods include the use of the devices described herein. For example, apatient may be placed in a desired position, and then a device of thepresent invention may be adjusted to maintain the patient in a desiredposition. In other embodiments, a device of the present invention may beused to place the patient in a desired position. In further embodiments,a device of the present invention may be used to place and maintain apatient in a desired position. In some embodiments, the methods providea quick and easy method of positioning a patient with a singleinteraction with a device. In some embodiments, the methods permit oneto position the patient in a single movement or in a single contact witha device of the present invention.

By way of example, and with reference to FIG. 6, a device according tothe present invention may be appropriately positioned using, or notusing, gripping element 160 to manipulate and position base 10 on agurney, operating table, dentists' chair or any other suitable place. Apatient 1000 could be placed on a device of the present invention havingbase 10 such that the top of the patient's head is oriented with upperside 40 of base 10 and the patient's neck would be oriented with lowerside 50 of base 10. Such placement could be done before or afterpositioning of base 10. The patient could be appropriately placed onbase 10 with or without reference to an alignment guide 155 (see FIG.1). For example, a patient 1000 may be positioned such that thepatient's mouth is approximately in line with supports 110 (and/oralignment guide 155). Once positioned (or in some embodiments, as thepatient 1000 is positioned), mandible gap 150 (see FIG. 1) may beadjusted by moving support 110 along the x-axis, thereby increasingsupport width 140. In some embodiments, this may be done by pressing)button 230 on support 110 and moving support toward or away from base 10until support 110 is in a desired position and then releasing button 230to lock support 110 in place. In addition, support 110 may also beadjusted in the y-axis. In some embodiments, this may be done bydepressing height adjustment button 540 and moving support 110 in they-axis until support 110 is in a desired position and then releasingheight adjustment button 540. Moreover and as necessary, support 110 mayalso be adjusted in the w-axis or the z-axis. In some embodiments, thismay be done by depressing rotation adjustment button 550 and movingsupport 110 in the w-axis until support 110 is in a desired position andthen releasing rotation adjustment button 550. Such procedure may berepeated for the support 110 on the other side of base 10. In someembodiments support 110 is positioned relative to patient 1000 such thatrotational movement of support 110 (and mandible arm 120) in the w-axismay tilt the patient's head back such that the patient's airway isopened.

The various adjustments (done only as necessary) may be done untilmandible arm 120 contacts the patient in such a way that the patient isplaced and/or maintained in a desired position. For example,adjustment(s) may be made until mandible pad 130 contacts one or morepoints of the patient's jaw. In some embodiments, the adjustment(s) willbe made until the mandible pad 130 contacts the ramus 930 of a patient'sjaw, the body 910 of the patient's jaw and the angle 920 of a patient'sjaw.

Thus, it is seen that devices and methods are provided. One skilled inthe art will appreciate that the present invention can be practiced byother than the various embodiments and preferred embodiments, which arepresented in this description for purposes of illustration and not oflimitation, and the present invention is limited only by the claims thatfollow. It is noted that equivalents for the particular embodimentsdiscussed in this description may practice the invention as well.

While various embodiments of the present invention have been describedabove, it should be understood that they have been presented by way ofexample only, and not of limitation. Likewise, the various figures maydepict an example configuration for the invention, which is done to aidin understanding the features and functionality that may be included inthe invention. The invention is not restricted to the illustratedexample configurations, but the desired features may be implementedusing a variety of alternative configurations. Indeed, it will beapparent to one of skill in the art how alternative functional, logicalor physical configurations may be implemented to implement the desiredfeatures of the present invention. Also, a multitude of differentconstituent part names other than those depicted herein may be appliedto the various parts or elements. Additionally, with regard to methodclaims, the order in which the steps are presented herein shall notmandate that various embodiments be implemented to perform the recitedfunctionality in the same order unless the context dictates otherwise.

Although the invention is described above in terms of various exemplaryembodiments and implementations, it should be understood that thevarious features, aspects and functionality described in one or more ofthe individual embodiments are not limited in their applicability to theparticular embodiment with which they are described, but instead may beapplied, alone or in various combinations, to one or more of the otherembodiments of the invention, whether or not such embodiments aredescribed and whether or not such features are presented as being a partof a described embodiment. Thus the breadth and scope of the presentinvention should not be limited by any of the above-described exemplaryembodiments.

Terms and phrases used in this document, and variations thereof, unlessotherwise expressly stated, should be construed as open ended as opposedto limiting. As examples of the foregoing: the term “including” shouldbe read as meaning “including, without limitation” or the like; the term“example” is used to provide exemplary instances of the item indiscussion, not an exhaustive or limiting list thereof; and adjectivessuch as “conventional,” “traditional,” “normal,” “standard,” “known” andterms of similar meaning should not be construed as limiting the itemdescribed to a given time period or to an item available as of a giventime, but instead should be read to encompass conventional, traditional,normal, or standard technologies that may be available or known now orat any time in the future. Likewise, where this document refers totechnologies that would be apparent or known to one of ordinary skill inthe art, such technologies encompass those apparent or known to theskilled artisan now or at any time in the future.

A group of items linked with the conjunction “and” should not be read asrequiring that each and every one of those items be present in thegrouping, but rather should be read as “and/or” unless expressly statedotherwise. Similarly, a group of items linked with the conjunction “or”should not be read as requiring mutual exclusivity among that group, butrather should also be read as “and/or” unless expressly statedotherwise. Furthermore, although items, elements or components of theinvention may be described or claimed in the singular, the plural iscontemplated to be within the scope thereof unless limitation to thesingular is explicitly stated.

The presence of broadening words and phrases such as “one or more,” “atleast,” “but not limited to” or other like phrases in some instancesshall not be read to mean that the narrower case is intended or requiredin instances where such broadening phrases may be absent. Additionally,the various embodiments set forth herein are described in terms ofexemplary block diagrams and other illustrations. As will becomeapparent to one of ordinary skill in the art after reading thisdocument, the illustrated embodiments and their various alternatives maybe implemented without confinement to the illustrated examples. Forexample, the figures and their accompanying description should not beconstrued as mandating a particular configuration, including aparticular geometry of the various parts and elements.

1. A device comprising: a base comprising a plurality of supports,wherein the base is configured to substantially accommodate a patient'shead, wherein each support comprises a mandible arm, wherein eachmandible arm is configured to contact a patient's jaw; and wherein eachmandible arm is movable in three axes such that each mandible arm ispositionable to be in contact with a patient's jaw and to maintain apatient in a desired position.
 2. The device of claim 1 wherein the baseis rectangular.
 3. The device of claim 1 wherein each mandible arm ispositionable to be in contact with a patient's jaw at three points. 4.The device of claim 1 wherein each mandible arm comprises a mandiblepad.
 5. The device of claim 4 wherein each mandible pad comprises foam.6. The device of claim 4 wherein each mandible arm is positionable suchthat the mandible pad is in contact with a patient's jaw at one or morepoints.
 7. The device of claim 4 wherein each mandible arm ispositionable such that the mandible pad is in contact with a patient'sjaw at three points.
 8. The device of claim 1 wherein each mandible armis removably connected to the supports.
 9. The device of claim 1 whereineach mandible arm is movable relative to a support.
 10. The device ofclaim 1 wherein the three axes are the x, y and w axes relative to thepatient.
 11. The device of claim 1 wherein the desired position is thesniffing position.
 12. The device of claim 1 wherein each support ismovable relative to the base.
 13. The device of claim 12 wherein eachsupport is movable relative to the base in two axes.
 14. The device ofclaim 1 wherein each support is movable relative to the mandible arms.15. The device of claim 1, wherein each mandible arm extends from acircumference of a rotatable portion of a support.
 16. The device ofclaim 1, wherein the base further comprises a head rest configured toprovide flexion of the patient's neck by elevation of the patient'shead.
 17. The device of claim 1, wherein supports and the rotatableportions are adjustable while the patient is in contact with themandible arms.
 18. A method for positioning a patient comprising thesteps of: providing the device of claim 1; placing the patient's headsubstantially on the base; placing the patient's head in a desiredposition; moving the mandible arms to contact the patient's jaw; whereinthe contact of the mandible arms on the patient's jaw providessufficient force to substantially maintain the patient's head and/or jawin a desired position.
 19. A mandible arm comprising: a curved portion,wherein the curved portion is substantially rigid; a mandible pad,wherein the mandible pad is flexible, and wherein the mandible pad has adistal side configured to attach to the curved portion and a proximalside configured to contact a patient's jaw at a plurality of points; anda connector portion wherein the connector portion is configured toattach to a support.
 20. The mandible arm of claim 19, wherein themandible pad comprises foam.